Bismuth toxicity: a rare cause of non-convulsive status epilepticus
Introduction Bismuth is a heavy metal that is used for therapeutic purposes including over the counter formulations. Here we describe a case of status epilepticus related to bismuth toxicity.Case report A 77-year-old woman had witnessed seizures at home which continued as status epilepticus in the h...
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| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Toxicology Communications |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/24734306.2025.2492977 |
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| author | Tyler Maggio Nancy Mikati Boulos Nassar Marielle Brenner Daniel McCabe |
| author_facet | Tyler Maggio Nancy Mikati Boulos Nassar Marielle Brenner Daniel McCabe |
| author_sort | Tyler Maggio |
| collection | DOAJ |
| description | Introduction Bismuth is a heavy metal that is used for therapeutic purposes including over the counter formulations. Here we describe a case of status epilepticus related to bismuth toxicity.Case report A 77-year-old woman had witnessed seizures at home which continued as status epilepticus in the hospital. Neuroimaging did not reveal a cause of seizures, which continued despite correction of various metabolic derangements. Lumbar puncture later did not reveal signs of infection. She eventually required numerous antiepileptic agents to maintain burst suppression. Bismuth concentrations were elevated in the urine (5800 mcg/L) and cerebrospinal fluid (1.8 mcg/L).Discussion Status epilepticus is a neurologic emergency that requires hospitalization with a variety of potential causes including bismuth intoxication. Recent initiation of bismuth subsalicylate and high concentrations in the urine and cerebrospinal fluid support bismuth toxicity as the cause of refractory status epilepticus in this patient. |
| format | Article |
| id | doaj-art-bb95a6e4b53d4271b6e0393de22ca298 |
| institution | OA Journals |
| issn | 2473-4306 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Toxicology Communications |
| spelling | doaj-art-bb95a6e4b53d4271b6e0393de22ca2982025-08-20T02:11:50ZengTaylor & Francis GroupToxicology Communications2473-43062025-12-019110.1080/24734306.2025.2492977Bismuth toxicity: a rare cause of non-convulsive status epilepticusTyler Maggio0Nancy Mikati1Boulos Nassar2Marielle Brenner3Daniel McCabe4Department of Internal Medicine, University of Iowa Health Care, Iowa City, IA, USADepartment of Emergency Medicine, University of Iowa Health Care, Iowa City, IA, USADepartment of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa Health Care, Iowa City, IA, USADepartment of Emergency Medicine, Division of Medical Toxicology, University of Iowa Health Care, Iowa City, IA, USADepartment of Emergency Medicine, Division of Medical Toxicology, University of Iowa Health Care, Iowa City, IA, USAIntroduction Bismuth is a heavy metal that is used for therapeutic purposes including over the counter formulations. Here we describe a case of status epilepticus related to bismuth toxicity.Case report A 77-year-old woman had witnessed seizures at home which continued as status epilepticus in the hospital. Neuroimaging did not reveal a cause of seizures, which continued despite correction of various metabolic derangements. Lumbar puncture later did not reveal signs of infection. She eventually required numerous antiepileptic agents to maintain burst suppression. Bismuth concentrations were elevated in the urine (5800 mcg/L) and cerebrospinal fluid (1.8 mcg/L).Discussion Status epilepticus is a neurologic emergency that requires hospitalization with a variety of potential causes including bismuth intoxication. Recent initiation of bismuth subsalicylate and high concentrations in the urine and cerebrospinal fluid support bismuth toxicity as the cause of refractory status epilepticus in this patient.https://www.tandfonline.com/doi/10.1080/24734306.2025.2492977Non-convulsive status epilepticusbismuthheavy metal toxicity |
| spellingShingle | Tyler Maggio Nancy Mikati Boulos Nassar Marielle Brenner Daniel McCabe Bismuth toxicity: a rare cause of non-convulsive status epilepticus Toxicology Communications Non-convulsive status epilepticus bismuth heavy metal toxicity |
| title | Bismuth toxicity: a rare cause of non-convulsive status epilepticus |
| title_full | Bismuth toxicity: a rare cause of non-convulsive status epilepticus |
| title_fullStr | Bismuth toxicity: a rare cause of non-convulsive status epilepticus |
| title_full_unstemmed | Bismuth toxicity: a rare cause of non-convulsive status epilepticus |
| title_short | Bismuth toxicity: a rare cause of non-convulsive status epilepticus |
| title_sort | bismuth toxicity a rare cause of non convulsive status epilepticus |
| topic | Non-convulsive status epilepticus bismuth heavy metal toxicity |
| url | https://www.tandfonline.com/doi/10.1080/24734306.2025.2492977 |
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